MASS design group completes butaro hospital in rwanda

the burera district was one of the most under-served parts of rwanda, one of the last two areas in the country lacking a regional hospital. massachusetts-based non profit firm MASS design group pooled its resources and designed ‘butaro hospital’ as part of a program of partners in health and in collaboration with the government of rwanda. bringing together infectious disease specialists as well as brigham and women’s hospital and harvard medical school to effectively mitigate and reduce the transmission of airborne illnesses, the architecture works with the program, using design strategies in plan, patient and staff circulation and natural cross-ventilation.

one of the hospital’s outdoor paths
image © iwan baan (also main image)

the architecture takes advantage of the temperate climate to create a network of outdoor spaces and a ventilation strategy that changes the air in the ward at least a dozen times an hour using a simple stack principle, wherein hot air rises and is ejected from the building. high-vaulted ceilings and slow moving fans also promote the gentle movement of air. the hilltop campus is a series of terraced gardens, open courtyards and covered verandahs, that serve the dual purpose of creating gathering areas and preventing infection by eliminating enclosed spaces where possible.

the layered envelope is visible during the ribbon cutting ceremony
image © jay cody

additionally, color coded signs are employed to help patients and families navigate the veranda system and prevent cross-contamination between wards. a spatial triage system is designed to assist the most vulnerable and immune-compromised patients. the architects prioritized air quality as a central design problem because tuberculosis is a leading killer along with HIV; many clinics became sites of infection rather than places for finding care. the building solves to create new standards where infection control becomes a design strategy.

the sloped site required circulation solutions that incorporated the surrounding greenery
image © jay cody

outdoor courtyards become gathering spaces
image © iwan baan

the hospital can become a site for disease prevention instead of intended transmission
image © clinton foundation

the 150-bed flagship facility now serves over 400,000 people and saved 2 million dollars in construction fees by implementing a coordinated construction plan that involved a combination of locally sourced materials, local builders and sustainable practices while employing some 3500 members of the community. volcanic rock from the virunga mountain chain creates one layer of the two-tiered building envelope while the sloped site was fitted with a network of walkways, ramps and stairs. low stone walls double as resting and seating areas, while allowing views of the northern rwandan landscape. the stone-clad labs, wards and treatment centers used ‘jigsaw’ joint technique previously unseen in rwanda and created by on-site local masons. the program includes surgical suites, an emergency room, a pediatric ward, intensive care units and an IT room.

wireless internet is available throughout the hospital and laptop computers can be found at every nursing station. they technology serves the double purpose of serving patients and also allowing medical staff access to educational resources or expert consultations for difficult cases. the architecture’s regard for low-tech measures for patient safety and pertinent, technologically advanced systems make the hospital a model of rural healthcare delivery.

locally sourced stone can become landscaped space
image © jay cody