Towards a contemporary interpretation of traditional architecture
Building a new hospital on another continent involves development on two fronts: the development of the architect comes before that of the project. It is first of all necessary to spend time taking in the atmosphere of the host country and to understand its customs and idiosyncrasies. The development of the project can then begin. The outcome is contextually appropriate architecture that is in tune with the climate and energy-efficient.
Initial development – Project design begins on site. Feeling the presence of the ocean, the colour and heat of the sand, and the wind blowing from the open sea or the desert. Then wandering the city, hanging around ongoing construction sites, enquiring about construction practices and available materials, and visiting existing hospitals to understand their daily operations. Before the first sketch, visits to the Dakar’s hospitals helped us identify a major challenge for the project: How to manage the flows of patients and their families to facilitate the work of the health care teams?
Subsequent development – The layout of the hospital is based on a medical axis surrounded by several concentric envelopes that serve as filters between hospital activities and the public. These filters ensure the management of flows and enable staff to care for patients in optimum conditions.
The wall that surrounds the 12-hectare site forms the boundary of a park in the city and is the first filter. It also establishes a hierarchy between the hospital’s different access points based on the nature of the public, medical or logistical flows. The outskirts of Dakar are experiencing continuous real estate pressure and the setting aside of a huge semi-public garden is a gift to the district. The distribution and public waiting areas that occupy the periphery of the hospital buildings are the second filter. Starting from the entrance porch, the public access the outpatient services, the emergency department and the in-patient wards without entering the heart of the hospital. A third filter has been set up before the emergency department. A patient triage system has been implemented to avoid congestion of the department and to redirect minor cases to the clinics. At the heart of the project, the central gallery is reserved for medical staff, logistics and patient transfers.
The distribution of services on either side of the medical gallery is very simple. On one side, the in-patient wards are located on two levels and, on the other, the out-patient services are located on the ground floor and the interventional services on the first floor. The logistical areas are located in the basement on either side of the central distribution axis. The three floors are connected by banks of bed lifts and goods lifts and a ramp for use in the event of a technical failure.
Finally, the teaching programme provided from the outset for the possibility of expanding the capacity from 300 to 500 beds by adding teaching and research spaces, and staff housing to create a dedicated medical campus. The concept for the hospital incorporates this dynamic process of expansion. The central gallery and the peripheral galleries are designed to be extended towards the sea and incorporate new wings.
Case study - CHWAPI
How do we make a major hospital a good neighbour?
Sand and seashells
Based on a bioclimatic and low-tech approach, the conceptual philosophy offers a contemporary interpretation of traditional architecture consisting of gardens, solid walls and apertures proportioned for illumination, solar and natural ventilation control. It also favours the use of local materials and uses sophisticated technical equipment sparingly.
The starting for it all was siting that sought the least amount of earthworks possible. The project sits on the slope of the land such that the logistics basement slides under the building without requiring the significant movement of earth. The reasoning behind the North-South orientation of the main façades is to ensure effective protection from solar heat gain. Indeed, the sun’s relatively stable overhead position in the South is easily managed using horizontal protection systems.
The hospital unfolds around courtyards that provide both light and natural ventilation. In the in-patient wards, air circulation is enabled by apertures in the façades and aspiration chimneys that intersect the floors. The plants in the gardens generate micro-climates that cool the air entering the buildings. Air-conditioning is reserved for services requiring controlled air quality, such as the operating area and the laboratories. Photovoltaic panels supply a significant portion of the electricity required for cooling and refrigeration.
The frame and the floors are made of concrete filled with cinder blocks produced on site. The walls and roofs are insulated to reduce thermal gains within the building. The rendering of the façades has been produced by combining two local resources: ochre-coloured sand and crushed white seashells from the nearby coastline. The materials for finishings such as the plasterboard panels for the ceilings were also produced on site by craftspeople. Rainwater, a precious commodity in this sub-Saharan region, is recovered to be reused in the toilets and in garden irrigation.
“We sought to offer a contemporary interpretation of traditional sub-tropical architecture”
An exemplary modern and resilient public hospital
The project, initiated by the Senegalese state and financed by international funds, was delivered in 2016. Intended to be exemplary and one of the most modern hospitals in West Africa, the facility is of a very high technical standard and prioritises patient comfort and the safety of medical staff. The care wards comprise double rooms and single rooms with terraces. In the first half of 2020, the hospital was designated a reference centre in Senegal for the management of the health crisis caused by COVID-19.
This resiliency in a period of crisis is made possible thanks to the decisions that shaped the project design. First of all, the distribution of the services over three levels and the organisation of flows ensure a clear separation of medical, public and logistical flows while minimising the risks of poor accessibility in the event of lift failure. To deal with every eventuality, an access ramp serving all floors has been incorporated into the central gallery. This gallery is designed to be extended and we have already planned the apertures for the connection of additional wings. Every part of the building has been designed to be extendable on every level. The roof terraces are designed to be provisions for extension, since the structure has been sized to bear additional loads. Certain technical areas have also been slightly oversized so as to absorb the enlargement or modernisation of the facility in the future. In conceptual terms, we have really taken into account the requirements of flexibility and modularity that are essential for a resilient facility, with a view to the planned 200-bed extension.
Gallery of images
Immersion in the Dala Jamm hospital during the COVID-19 pandemic (in French)
© Medi1TV Afrique
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