Speaking at a conference in Rwanda in 2013, Dr. Paul Farmer, co-founder of Partners in Health, said, “Rwanda is a theater of something extraordinary. This is a country that can teach a lot to other settings in the world, including the United States. Everything you see here has been done through collaboration and taking on problems.”
It is in this spirit of collaboration and creatively addressing problems that the Rwinkwavu Operating Rooms and Neonatal ICU project was designed and constructed. The project is the recipient of a 2015 SEED Award, an annual honor conferred by Design Corps for design projects that have made an exceptional impact in three key areas of development: social, economic, and environmental. The award panel jury had this to say of the project: This is “Capital A” Architecture that meets a critical public health need. It is a beautiful building involving training of local builders in extending traditional construction methods into new configurations and potentials.
The program for the Rwinkwavu Hospital facility addition, described in the Introduction, was developed by the Rwandan Ministry of Health. MASS Design Group, who previously worked with the Rwandan Ministry of Health and Partners in Health on the Butaro Hospital in Burera, Rwanda, was invited to design the project and oversee construction.
To initiate the design process, MASS Design Group team met with groups of doctors, patients, and administrative staff to gather and document their concerns and priorities for the addition. Discussions with both the Ministry of Health and local staff and patients illuminated functional issues as well as social norms that needed to be addressed in the design.
One functional challenge was the physical connectivity of the proposed addition to the existing facility. The hospital site is hilly, and the circulation route between the new addition and an existing building called Block One, which houses the Post-Operative wards, has a large drop in elevation. The solution was a series of retaining walls and gently sloping ramps that enable the hospital staff to transport the patients to the Post-Operative ward after their surgical procedures.
For the design of the addition, simple, local materials were selected. These included local stones for the retaining walls, standard fired-clay bricks for wall infill, and steel and wood for the doors and windows. The use of these simple materials kept project costs low and helped reduce the ecological footprint for the project, as all of the materials were acquired locally.
Many parts of the building were built in a very standard way for the area. However, other portions of the building design challenged local craftspeople to use the materials in ways that differ from typical Rwandan construction. This mix of both traditional and unusual use of familiar materials gave local workers a richer construction training experience. Christian Benimana explains, “a blend of both allowed us to create great architectural elements using the exact same materials the workers were used to working with, which circles back to improve on the way they were using these same materials before.”
With the exception of the Operating Rooms, the remainder of the addition is fully day-lit through windows. The rooms have various orientations and proportions of windows - some high and long, others narrow and tall, depending on the level of privacy required for the space.
The facility was designed for natural cross-ventilation. This is facilitated by a system of high and low windows. This natural system, in combination with mechanical systems, also promotes infection control as it moves fresh air through and out of the spaces.
The landscaped outdoor waiting areas employ a combination of shading techniques, as the structure is located in one of the hottest regions of the country. The benches which are integral to the building walls are shaded by the structure, while the benches which are a part of the landscape retaining walls are shaded by trees and other plantings. Additionally, the presence of these outdoor spaces to draw visitors out of the building reduces the heat-load in the building.