Butaro Hospital: A Standard for Sustainable Healthcare in Rwanda by MASS Design Group
The Butaro Hospital is a breathtaking building with intricate lava rock walls made of stones cut by Rwandan masons, and it is full of brightly coloured accent walls and breeze-ways bathed in light and air. Deep-green flora blossom everywhere. For the 340,000 people who live in this region of Northern Rwanda, the project marks a literal reclamation: an area that was once a site of genocidal violence is now a centre for state-of-the-art medical care. Healing happens there – an unmistakable grace permeates this place.
To design the hospital MASS Design Group made use of local materials – such as nearby volcanic rock from the Virunga Mountains – and labour intensive practices to deliver appropriate and sustainable design as well as stimulate the local economy through employment. This approach reduced the facility’s price tag to roughly two thirds of what a comparable hospital would typically cost in Rwanda, saving not only 2 million dollars in construction fees but also providing over 4,000 jobs.
Due to crowded corridors and insufficient ventilation, patients and healthcare providers in Rwanda were often subjected to the high risk of contracting airborne diseases inside health facilities, particularly in rural, impoverished settings. The design of Butaro Hospital sought to mitigate and reduce the transmission of airborne diseases through several systems including: overall layout; patient and staff flow; and natural ventilation – providing a template and approach that could be replicated in areas of high risk for TB transmission and other airborne diseases in resource-limited scenarios.
Still on innovative design interventions, interior corridors were eliminated and large-radius fans and louvred windows were installed to ensure frequent air exchange, a key strategy in reducing transmission. Germicidal UV lights were installed to kill or inactivate microbes as air is drawn through the upper regions of the room. Moreover, the use of a non-permeable, continuous floor finish provided a surface devoid of joints prone to bacterial growth. The floor type is easy to clean, durable, and safe for resisting infection.
Beyond providing access to first-rate healthcare facilities, the project was used as a way to spur grass-roots business and development. Constructed with 100% local labour, 3,898 people were trained and hired to help excavate, construct, and manage the project. Construction teams were organized into six teams, each of which worked a two-week shift. This allowed for six times as many people to be hired and be involved in the building process. All employees were provided with food, water, and healthcare. Employing more labourers was cheaper and faster than using solely heavy equipment to excavate the hillsides and move the earth — but more importantly, it provided the added benefits of both creating jobs and engendering community investment in the project.
Architect: MASS Design Group
Client: Rwandan Ministry of Health & Partners In Health
Location: Burera District, Rwanda
Design Team: Michael Murphy, Alan Ricks, Sierra Bainbridge, Marika Clark, Ryan Leidner, Garret Gantner, Cody Birkey, Ebbe Strathairn, Maura Rockcastle, Dave Saladik, Alda Ly, Robert Harris, Commode Dushimimana, Nicolas Rutikanga
Structural Engineering: ICON
Landscape Design: Sierra Bainbridge, Maura Rockcastle
Area: 6 040 sqm
Status: Completed, 2011
Photographs: Iwan Baan, MASS Design Group