Ronesans Healthcare Investment



Project number:


Business sector:

Municipal and environmental infrastructure

Notice type:


Environmental category:


Approval date:

28 May 2020



PSD disclosed:

23 Apr 2020

Project Description

Provision of a senior loan of up to EUR 40 million to Ronesans Holding A.S. ("Ronesans") and Ronesans Saglik Yatirim A.S. ("Ronesans Healthcare"), the umbrella company of Ronesans Holding, for healthcare sector investments. The proceeds of the loan will be used mainly to refinance short-term loans used for equity injections in the Istanbul Ikitelli PPP Hospital Project. The remainder will be used by RSY Saglik Ticari A.S., the commercial area management company, and RSM Isletme Hizmetleri A.S., the facility management company, for investments in the Istanbul Ikitelli PPP Hospital.

Project Objectives

The operation will enable Ronesans Healthcare to restructure its balance sheet and eliminate the maturity mismatch between its assets and liabilities by providing longer term financing not currently available in the market. In addition, the operation will promote gender and inclusion through the implementation of a Gender Equal Opportunities Action Plan and a comprehensive Gender Audit, reviewing the design of the Ronesans Healthcare facilities and service delivery methods at the Ikitelli PPP Hospital.

Transition Impact

ETI score: 67

The transition impact of the project will be derived from:

1) Gender and Inclusion: The project contributes to gender inclusion by strengthening equal opportunity measures, increasing women's employment in technical positions at Istanbul Ikitelli PPP Hospital and addressing employees' care burden.  A gender audit of the hospital facilities will further improve women's access to healthcare services by identifying key gender barriers related to the physical and operational characteristics of the facility.

2) Resilience: The project will strengthen Ronesans Healthcare's financial resilience through balance sheet restructuring to achieve a better alignment between the company's projected income from its operating companies and its debt service obligations.

Client Information


Ronesans Holding A.S. is a diversified conglomerate/holding company with activities in construction, real estate development and energy, incorporated in 1993. It operates in Turkey, Russia, Europe and various emerging markets in the CIS and MENA regions. Ronesans is owned 90% by Erman Ilicak, 4.75% by Ipek Ilicak and the remaining shares are held by IFC.


Established in 2012, Ronesans Saglik Yatirim A.S. operates under Ronesans Real Estate Development and is the investment vehicle of Ronesans Holding in the health sector. The company acts as the holding of operational entities responsible from the design, construction, operation and maintenance of healthcare facilities and providing certain services for a period of 25 years following the construction period.

EBRD Finance Summary

EUR 40,000,000.00

Total Project Cost

EUR 40,000,000.00


Higher inclusion standards: Ronesans Healthcare will benefit from the EBRD expertise on strengthening equal opportunities practices.

Environmental and Social Summary

Categorised B under the 2019 ESP. E&S Due Diligence (ESDD) included reviews of the Environmental and Social Impact Assessment (ESIA), Environmental and Social Action Plan (ESAP), Stakeholder Engagement Plan (SEP), the lenders' supervisor report (January 2020) and the 2019 annual Environmental & Social report to MIGA.  Furthermore, the Bank appointed  independent consultants who have reviewed the labour audit reports and life and fire safety audit report, discussed with the clients and assessed the Project's E&S performance against EBRD PRs (March 2020). Although no national EIA was required for the project, the Company  had carried out (on a voluntary basis) a full ESIA for the Project in accordance with IFC Performance Standards (PSs) and as required by the existing lenders. Non-technical Summary (NTS), ESIA, ESAP and SEP had been disclosed by the client.

The ESDD showed that the client has adequate E&S risk management capacities and the Project (under the lender technical supervisor's regular monitoring) has been developed in line with EBRD PRs to date.  However, the unfolding COVID 19 pandemic is imposing specific risks on the workforce during the current final phase of construction and possibly during the early days of the operation.  The consultants could not visit the site due to the travel restrictions resulting from the COVID 19 pandemic.  Approximately 6,000 construction workers are currently working and living on site. The client has already developed and implementing a COVID-19 risk assessment and a response plan.  The updated ESMS documentation including SEP for operation will also address the health and safety risks associated with COVID 19 pandemic and agreed with the client. 

ESDD confirmed that Environmental and Occupational Health & Safety (OHS) management have been carried out in accordance with ISO14001 and OHSAS18001. OHS induction and regular training, external and internal OHS audits regularly take place at the site.   

ESDD also shows that there are no resettlement and economic displacement associated with the project.  There is a minor risk of flood at a small parcel on the project site but the elevation difference between the creek bed and the Project site eliminates that risk. In addition, this particular parcel is free from any building structure. As the site is in an active seismic zone, the design was prepared based on the site specific seismic hazard & design based earthquake ground motion identification study, which was carried out in 2016. Chance finding procedures have been in place and no archaeological item has been found at the site. 

Noise, dust & emission have been monitored at the site throughout construction, and the findings are below the national permissible parameters. Water supply for the operational stage will come from the municipality.   Wastewater will be treated at the municipal wastewater treatment plan run by Istanbul Water & Sewage Administration (ISKI). Construction-related waste is sorted at the site.  During operation, medical waste will be incinerated at the medical incineration & sterilization plant in  Kemerburgaz, Odayeri.  Hazardous waste will be disposed of at the hazardous waste landfill in Sile Komurada.  In accordance with IFC's requirement, a Health Care Waste Management System (HWMS) will be implemented. 

The third party life & fire safety audit has been carried out. It was found that the main hospital's life and fire safety design provisions are not fully compliant with national and international standards while the other building are satisfactory against the standards. Therefore, a checklist and concrete actions have been listed, and these actions will be completed and will continue to be monitored by the LTA (lender's technical adviser).

Grievance mechanisms for the workers have been in place.  The third party consultants' review of three labour audits concluded that the audits were not comprehensive, lacking of references to compliant worker accommodation, disproportionate sampling (250 female workers not interviewed) and inadequacies in the grievance redress mechanism.   Therefore, EPC-C will strengthen construction worker labour management during the remaining construction period. 

The existing SEP included the following activities: holding dedicated meetings with governmental authorities and Civil Society Organisations (CSOs); soliciting opinions from governmental authorities (i.e. the Ministry of Health, Ministry of Culture & Tourism) and CSOs on the Project Information Document; and sending information packs to headmen of neighbourhoods.  The client organised a public consultation meeting on the draft ESIA and disclosed the final ESIA documentation to the public in 2014. The updated SEP needs to focus on the operational stage and reflect possible COVID 19 concerns.

The updated ESAP includes an ESM system for both the construction & operation including Medical Waste Management System (MWMS), construction labour and OHS management, a COVID 19 emergency response plan, a life & fire safety check list and action plan, infection management, Antimicrobial Resistance (AMR) awareness, grievance mechanisms for the workers and public amongst others. For the Project, the client is required to continue to implement the updated ESMS & SEP to comply with EBRD PRs and submit an annual E&S report to the Bank.  

Technical Cooperation and Grant Financing

Technical Cooperation of EUR 120,000 will be used in total for (i) an Equal Opportunities study to increase the share of women among the workforce of the Borrower and (ii) a comprehensive Gender Audit reviewing the Borrower's healthcare facilities' design and service delivery methods to identify opportunities to better serve women and children.

Company Contact Information

Inci Balkan
Ronesans Saglik Yatirim A.S.

Implementation summary

PSD last updated

23 Apr 2020

Understanding Transition

Further information regarding the EBRD’s approach to measuring transition impact is available here.

Business opportunities

For business opportunities or procurement, contact the client company.

For business opportunities with EBRD (not related to procurement) contact:

Tel: +44 20 7338 7168

For state-sector projects, visit EBRD Procurement:

Tel: +44 20 7338 6794

General enquiries

Specific enquiries can be made using the EBRD Enquiries form.

Environmental and Social Policy (ESP)

The ESP and the associated Performance Requirements (PRs) set out the ways in which the EBRD implements its commitment to promoting “environmentally sound and sustainable development”.  The ESP and the PRs include specific provisions for clients to comply with the applicable requirements of national laws on public information and consultation as well as to establish a grievance mechanism to receive and facilitate resolution of stakeholders’ concerns and grievances, in particular, about environmental and social performance of the client and the project. Proportionate to the nature and scale of a project’s environmental and social risks and impacts, the EBRD additionally requires its clients to disclose information, as appropriate, about the risks and impacts arising from projects or to undertake meaningful consultation with stakeholders and consider and respond to their feedback.

More information on the EBRD’s practices in this regard is set out in the ESP.

Integrity and Compliance

The EBRD's Office of the Chief Compliance Officer (OCCO) promotes good governance and ensures that the highest standards of integrity are applied to all activities of the Bank in accordance with international best practice. Integrity due diligence is conducted on all Bank clients to ensure that projects do not present unacceptable integrity or reputational risks to the Bank. The Bank believes that identifying and resolving issues at the project assessment approval stages is the most effective means of ensuring the integrity of Bank transactions. OCCO plays a key role in these protective efforts, and also helps to monitor integrity risks in projects post-investment.

OCCO is also responsible for investigating allegations of fraud, corruption and misconduct in EBRD-financed projects. Anyone, both within or outside the Bank, who suspects fraud or corruption should submit a written report to the Chief Compliance Officer by email to All matters reported will be handled by OCCO for follow-up. All reports, including anonymous ones, will be reviewed. Reports can be made in any language of the Bank or of the Bank's countries of operation. The information provided must be made in good faith.

Access to Information Policy (AIP)

The AIP sets out how the EBRD discloses information and consults with its stakeholders so as to promote better awareness and understanding of its strategies, policies and operations following its entry into force on 1 January 2020. Please visit the Access to Information Policy page to find out what information is available from the EBRD website.

Specific requests for information can be made using the EBRD Enquiries form.

Independent Project Accountability Mechanism (IPAM)

If efforts to address environmental, social or public disclosure concerns with the Client or the Bank are unsuccessful (e.g. through the Client’s Project-level grievance mechanism or through direct engagement with Bank management), individuals and organisations may seek to address their concerns through the EBRD’s Independent Project Accountability Mechanism (IPAM).

IPAM independently reviews Project issues that are believed to have caused (or to be likely to cause) harm. The purpose of the Mechanism is: to support dialogue between Project stakeholders to resolve environmental, social and public disclosure issues; to determine whether the Bank has complied with its Environmental and Social Policy or Project-specific provisions of its Access to Information Policy; and where applicable, to address any existing non-compliance with these policies, while preventing future non-compliance by the Bank.

Please visit the Independent Project Accountability Mechanism webpage to find out more about IPAM and its mandate; how to submit a Request for review; or contact IPAM  via email to get guidance and more information on IPAM and how to submit a request.


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