Building health in Rwanda

The designers quickly realized that the challenge was not simply to draw up plans, as they had first thought, but rather to understand the spread of airborne disease and design a building that would combat - and in some cases sidestep - the unhealthy conditions common to so many hospitals.

Learning from health care workers that hospital hallways were known sites of contagion, poorly ventilated, and clogged with patients and visitors, MASS Design decided that the best solution would be to get rid of the hallways. Taking advantage of Rwanda’s temperate climate, they placed the circulation outdoors, designing open verandas running the lengths of the buildings. Color-coded interior walls showed illiterate visitors where to go, and minimized the chance that contagious patients would accidentally wander into wards where they didn’t belong.

MASS Design also re-thought the traditional configuration of the wards. Instead of placing the heads of the beds against the outside walls, the designers positioned the beds against a low partition running down the center of the ward. Removing the beds from the perimeter allowed for large windows; patients could look out at the landscape, and ventilation was significantly improved. The partition was designed to house electrical systems and oxygen, and to be adaptable to future technological upgrades. Large fans, vents placed just below the ceilings, and germicidal ultraviolet lighting fixtures further improved ventilation and cleaned the air. And, in their quest for natural ventilation, the designers recommended siting the hospital on a high, breezy hill that was being used by Rwanda’s military - and the military agreed to move.