Fort Liberte Medical Clinic - Erin + Emmie

Our goal for the addition of the existing medical clinic is to provide a larger facility that blends in with the Haitian surroundings, as well as make the patients and staff feel as comfortable as possible. We intend to implement this by utilizing passive ventilation and natural lighting as much as possible, and to thoughtfully consider the materials used throughout the project. Another important element is clear flow of circulation between the patients, the patient and staff members, and the staff alone.

The design was modified to include all of these aspects, as well as considering the sustainability of the building in regards to materials and the durability. We also considered the phasing of the project to help with the ease of construction.

After talking with several professionals and the nursing students at the Foundry event, suggestions, critiques, and praise were given about the current direction of our project. The idea of the clear circulation and the division between patient and staff areas was a positive aspect. As well as a central courtyard is important for the passive ventilation in addition to the calming effect.

Our next steps will be to consider all of the feedback given from the different professionals and nursing students. We will consider the circulation and placement of each program element. In addition the layout of the design, the exterior façade will be a major consideration to assist in directions and clarity. Another important element that will be addressed is the courtyard and how that helps with certain aspects of the circulation, aesthetics, and ventilation.

Clinic at Fort Liberte - Team Sawyer, Sherborne, & Wetherington

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 Much of Haiti's population cant read. Many have never been to a hospital. The medical need is so great that people will wait all day at a health care provider for the possibility of receiving care.

Our goal is to create a clinic that takes into consideration the patient experience and projects an image of professionalism, order and safety for its visitors.

As a patient, the first thing that you would receive upon checking into the facility is a card with a color on it. You would then be directed to go to the waiting room with the color that correspond to your card. The purpose of this system is to avoid both crowding and  confusion in the clinic: reduce crowding by spreading out the waiting areas, and reduce confusion by enabling the doctors to find their patients in the correct room color.

The only section of the main building that is completely enclosed is the single stretch of room at the core. Circulation and waiting are covered porches that look out onto a central courtyard. this allows for potential overflow space, natural ventilation and shading. This will also make it simpler to vent the core rooms by using a perforated wall on the east and south sides while maintaining privacy with a clearstory section on the west and north sides that encourages airflow through the rooms.

Another Important consideration for the function of the space is the path of circulation - or paths as the case is here. The types and range of treatments needed for patients will vary and it is important for movement through the facility to remain comprehensive and as uniform as possible. As such, we have taken into careful consideration the positioning of the entry, exit and used spaces so that no matter what you come to the clinic for, your journey through it remains relatively the same.

Doctors on Demand

Early on in the project we were dubbed the “maximalists” for taking on issues of mobile healthcare at a large scale. Not having been to Haiti, it was very helpful working with Aaron Brown and Lauren Metts, who had a great sense of the landscape as well as the culture. We started by looking at ambulances/fire trucks and customizing it to fit our needs for a mobile medical unit. However, the unpredictable roads in Haiti would have made it difficult to justify our reasoning for this design. So instead we looked at the idea of a dump truck, or a system where a truck drops off a unit for an extended period of time then retrieves it when more supplies are needed. This way, the units could function as extensions of a hospital in Haiti and get medical treatment closer those in rural areas.

      

Luckily, Aaron Brown has an extensive knowledge of the technical aspects of these trucks (which is still pretty unfamiliar to me). Basically, the unit would leave the hospital compacted, dropped off at a particular location, then expanded to create three separate observation areas, one interior and two exterior. The exterior spaces are shaded by RV-like awnings that extend from the unit. There is enough storage for all medical needs, as well as tools and staff storage. Ventilation was also an important issue we addressed by leaving openings at the bottom and top of each unit.  

One of the strengths of our project was how we incorporated it into the culture. Like the Tap Taps seen all over the country, we decided that the units could be painted by the locals or possibly with educational information so that the objects do not seem so foreign. Our project was designed for healthcare providers to stay for extended periods of time. However, one of the weaknesses of our project was the sleeping arrangement. While we had incorporated beds into our design, realistically this would not be very comfortable for the doctors and nurses. Overall, I think we had a really strong idea that could have been taken even further with more time.

Emergency Response Unit: Doctors on Demand

Unit Enroute to Disaster ZoneWith a background in emergency services and a few years of designs for Haiti under my belt, I was excited to begin this project.  My initial idea was to revisit the idea of an ambulance, adapting it for post disaster Haiti.  After working through several iterations with Caroline McDonald and Lauren Metts, we decided that due to the lack of resources post disaster dedicating a vehicle to a emergency response unit was a poor idea.  We then worked through the way that we could deliver a emergency response unit that could function as a self-sustainable medical clinic. 

We looked at the way PODS (portable on demand storage) units are delivered, as well as dumpsters that are rolled off of a truck here in the states.  We decided to utilize the mechanics of these systems to remove our unit from the back of a typical Haitian cab over truck.  Our unit is designed to be removed from the back of a cab over chassis with a hand winch and removable jacks.  After removal from the chassis, the removable jacks can be utilized to level the unit on uneven terrain.

Unit being removed from cab over truck

We designed the unit to accommodate a four person medical crew in the shelter of the unit.  Retractable awnings with removable sides on each side provide for a flexible layout that can accommodate most any needs.  The interior of the unit contains bulk medical supplies and sleeping quarters for the staff.  In the event that a extremely private exam is necessary, the interior bunks can be utilized for just such an exam.  Exterior storage includes a large rescue style compartment that contains removable benches, spine boards, and various tools that could be used in collapse rescue situations.  Two compartments that open downward on each side become a work surface for a medical provider and contain a limited amount of necessary medical supplies.

Living conditions on the interior are tight, but comfortable.  The top bunks fold up to allow extra head room for the bottom bunks to become a bench during the day.  Storage is included under the bottom bunks to utilize every inch of space.  A water storage tank can store in excess of 600 gallons of clean water to be used as the medical personell see fit.  Ventilation is provided by small ports at floor level that introduce fresh air into the unit, and a large vent along the center of the roof structure that exhausts the air from within.  A small amount of electricty could be produced by photovoltaic panels mounted to the top of the unit.  This electricty could be used to charge two way radios, cell phones, or life saving medical equipment.

In order for this unit to become a piece of the Haitian culture, it is designed to be based at a local hospital.  Post disaster, the unit will be dispatched to the disaster area and delivered by a modified cab over truck.  After initial set up, the unit will begin functioning as designed.  To alleviate concerns of the Haitian people about the origins of the unit, it is design to accomodate typical colors seen in Haitian healthcare environments.  Local Haitians could paint a mural on the exterior of the unit, eventually turning the unit into a mobile canvas that tells a story of the disasters it has seen or good hygenie practices.Unit awaiting initial setup

Mobile Medical Clinic | Dump Light

After working with Aaron Brown and Caroline McDonald on the beginning stages of our mobile medical unit, I broke off and started a new analysis of program and needs of a Haitian mobile medical clinic moving around Haiti.

I found that we had already addressed several important issues; however, I decided to make a few changes.

INSERT PIC OF WALL

I created a smaller version of our original ‘Dump Truck’ design, one that could be more applicable and in use in a more common way. The size made it more accommodating for any regular size bed of a pick up truck. It was meant to be (mostly) of a steel material, and once planted onto a site, it was designed to unfold into a multi space unit.

Because Haiti’s medical experience is several years behind the United States and our techniques and processes, I had to take numerous things into consideration. There, the pharmacy is meant to be separate from the actual medical examination process. I took this into account by allowing the actual original unit to become the secured pharmacy one arrival, helping to separate the check in/waiting area from the examination area.

 

Since this specific design is reliant on a vehicle, I provided an option for non-truck use, which would include using the main shelf wall located within the actual unit. The wall would actually be composed of backpacks with drawers and shelves, meant to remain on the wall, but with the possibility of pulling out and being carried on individual’s backs.

One of the main critiques I have come across with existing mobile clinics around Haiti is that most of them are designed to last a day, and there are well over double the amount of people that actually need to be seen. With this, the overall unit is meant to act as a multiday clinic, stocked with supplies to last for 4-5 days. Personal supplies for the workers and people visiting the clinic will be stored inside the unit and pulled out and used when needed (cots, benches, chairs, work surfaces).