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How to build a surgical facility in rural Africa

by Ofentse Sefolo
How to build a surgical facility in rural Africa

Surgical Facility, rural Uganda
By Kliment Halsband Architects

Healthcare architecture is typically associated with high-performance building design and high-tech features and equipment – buildings that require many resources to be run effectively. But what about areas where there are no potable water, reliable electricity, Internet access or even just adequate sanitary facilities?

Kyabirwa, a rural village near the equator in Uganda, was such a resource-poor site, where New York firm, Kliment Halsband Architects, designed and constructed an independent, self-sustaining ambulatory facility capable of providing surgical treatments.

In fact, the project has been developed as a replicable prototype facility for similar areas and serves as proof that even access to specialised medical services such as surgery can be provided in inexpensive, uncomplicated buildings.

“Careful analysis of required systems and equipment resulted in the elimination of many redundant complex and costly systems typically found in high-tech urban hospitals,” comments the architects.

Simple construction
The building was designed with a focus on simplicity of construction. The materials and technical systems are minimally invasive and were carefully selected based on availability and local labour skills, also to ensure that the building can be maintained in the future. Modular building forms further simplified construction.

Aesthetically, according to the architects, the idea for the project was “to relate to the surrounding architecture while adding contemporary unique and visual elements. Red clay cladding tiles with wavy shapes reminiscent of the nearby White Nile were formed in custom, handmade moulds. In combination with the shade-providing solar roof, the brick structure tells the story of modern and vernacular technologies working together to improve lives”.

Red clay cladding tiles with wavy shapes reminiscent of the nearby White Nile were formed in custom, handmade moulds from red clay that was dug out of the ground near the building site.

Simple materials
Both the bricks and the tiles were made from red clay that was dug out of the ground near the building site and fired in a local kiln. This regionally sourced brick was utilised because of its availability, its historical presence in the area and to support the local economy. The bricks and tiles were laid in patterns of varying densities, forming screens that let in both light and air.

Solar “leaves” and uninterrupted power
To insure uninterrupted power, a combination of solar panels, battery storage and an onsite generator is used alongside the intermittent power from the grid. Interestingly, the banana plants on the site were the inspiration for the solar array that, like the leaves of the plants, absorbs the sun and provides shade for the simple structure underneath. Power generated from 75kWp solar panels is stored in Li-Lead Acid Hybrid battery storage that can run the surgical facility for up to two days.

Shade for the courtyard waiting area is provided by the solar array that, like a banana plant’s leaves, absorbs the sun.

Internet connection
A reliable Internet connection was also an essential part of the planning. About 32km of underground cabling brings fibre-optic services to the site. Telemedicine links to the Mount Sinai Hospital in New York provide access to advanced surgical consultation, with real-time operating room video conferencing.

Ventilation
With the exception of the operating rooms, the building is not air-conditioned, and relies on natural ventilation. The sloped roof provides high and low ventilation openings that facilitate natural air flow through the building using a stack effect, thus minimising the usage of electricity for ventilation and cooling.

Water and sanitation
Well water and intermittently available town water are stored in gravity tanks on site, and is filtered and sterilised on demand. Liquid sanitary waste is handled by a septic tank system and medical waste is incinerated on site as per the country’s health code. In addition, a greywater system collects roof rainwater and stores it in underground tanks to be used for flushing toilets and irrigating the on-site vegetable garden.

Even food
The vegetable gardens will help to provide food for patients and staff.

Overall, the construction of this facility has developed infrastructure for clean water, power and sewage disposal, while integrating into and advancing the local healthcare community.

Full thanks and acknowledgement are given to Kliment Halsband Architects for the information given to write this article.

 

The Kyabirwa Uganda Surgical Facility, designed by Kliment Halsband Architects, is a replicable prototype for an independent, self-sustaining ambulatory surgical facility for resource-poor areas.

The building was designed with a focus on simplicity of construction. The building materials were selected based on availability and local labour skills, also to ensure that the building can be maintained in future.

The bricks and tiles were laid in patterns of varying densities, forming screens that let in both light and air.

The banana plants on the site were the inspiration for the solar array that, like the leaves of the plants, absorbs the sun and provides shade for the simple structure underneath.

 

Two building wings flank the courtyard, which is shaded by the solar panels above.

With the exception of the operating rooms, the building is not air-conditioned, and relies on natural ventilation.

The construction of the Kyabirwa Uganda Surgical Facility has developed infrastructure for clean water, power and sewage disposal, while integrating into and advancing the local healthcare community.

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