Description

It is hard to tell which aspect of the district hospital is most fascinating: its elegant design, the humanitarian ideals that inspired it or the involvement of the community in order to get it built. US $ 553,800 were spent on local labor, providing employment for over 4,000 people who first excavated the site and were then engaged in construction work. The project was supported by Partners In Health (PIH), an organization founded by Dr. Paul Farmer and Ophelia Dahl in 1987. Originating in the liberation theology movement, PIH’s aim is to bring healthcare to the world’s poorest. For the Butaro District Hospital, the Rwandan Ministry of Health teamed up with Partners In Health and the Clinton Foundation in 2007.

Situated on a high hill that formerly housed military barracks, the hospital has been conceived as a collection of buildings that form a medical campus. The hospital has 140 beds, an outpatient cancer infusion center, housing for doctors and nurses and ample landscaped areas for the patients, their families and staff to enjoy.

Hygiene and infection control were the building’s primary design criteria. Specifically targeting airborne agents spreading infectious diseases, the design integrates a sophisticated system of natural ventilation with louvered windows that is supported by large industrial-grade fans that increase airflow and germ-killing UV lamps. Since hospital air is seen as the main cause of nosocomial diseases, it has to be continually replaced by fresh air from outside. The system refreshes the air 12 times per hour, meeting the minimum requirements of the World Health Organization. The entire building is designed to perform even during power outages. Since overcrowded corridors increase the risk of infections, hallways were minimized. The principal traffic infrastructure makes full use of the open spaces between the separate volumes, connecting several of them with covered pedestrian walkways and waiting spaces. The hospital’s dominant architectural feature is the use of dark, volcanic stone, a local material whose application to a building façade was pioneered at Butaro, resulting in beautifully textured walls. The seemingly unstructured, rough pattern of the stones, which are stacked with minimal use of mortar, offers a striking contrast with the neat, rectangular openings of windows and doors, and with the plastered walls, the ceilings and the floor. Color is used to create bright accents throughout the building.

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Originally published in: Cor Wagenaar, Noor Mens, Guru Manja, Colette Niemeijer, Tom Guthknecht, Hospitals: A Design Manual, Birkhäuser, 2018.