Eben-Ezer Medical Clinic Expansion | Ft. Liberte, Haiti

Haiti is a very impoverished nation where organized, public healthcare is virtually non-existent. The majority of the population has never experienced a clinic-type setting before and often time suffers from disease and sickness caused by unclean water. More than anything, there is an overwhelming sense of chaos and disorder throughout the nation.

Ground Floor Plan with paving patterns

Because Haiti is still a developing country, it was a necessity for the design of this medical clinic to accept and implement passive strategies with natural daylighting and natural ventilation. Using a series of screens to not only act as shading devices from harsh direct sunlight, but also as a permeable ‘wall’ in the main served spaces to allow for ventilation, these passive goals were able to be achieved.  

Diagram: Natural Ventilation and daylighting from green screen within exam rooms

View of circulation under green screen from back of site

Positioning the check-in at the entrance, seen instantly through the newly renovated existing clinic (which I had turned into a lower level colonnade), allowed an immediate recognition of the sequence and order of programmatic pieces. From the check-in one would move directly into the waiting area. With a direct correlation to the exam rooms, divided only by an elongated courtyard and the screens, the patient can begin to understand and visualize the next space they will most likely inhabit. From there, one would either move towards the observation and lab area, or on to the exit of the complex, where the pharmacy is located for a smooth and easy transition back out onto the street of Ft. Liberte.

 

Programming Diagrams

The clinic has been designed to blanket outside chaos with a calming sense of organization and wayfinding, applying bright colors found all around Haiti into the different programmatic elements within, also creating a sense of comfort and familiarity. Mostly, this medical clinic has been designed to allow the patient to leave with something more than they came in with: new-fangled knowledge.

 

Section A : Cutting through waiting/exam rooms and adjacent screens

Section B : Cutting through pharmacy/laboratory rooms with green screen in background

Section C : Cutting through observation/laboratory/exam spaces

Because of the lack of clean water in most regions of Haiti, I chose to implement a simplistic system of water collection, allowing this visual process to take place in the check-in and waiting area, where most, if not all, patients would find themselves at some point or another. From here, they would move into an exam room. En route, patients would pass by the central focus of the exterior courtyard, a solar still, which would be constantly distilling and filtering water throughout the day for the use of the clinic, providing them with a better understand of the way in which anyone can produce clean water.

Massing Site Axon showing ideal water collection routes

View looking into waiting/education spaces from back of site

Clinic Community

FUNCTION

Clinic Community strives to provide a variety of services to the citizens of Fort Liberté. In addition to serving as an innovative local clinic, the complex also provides educational services as well as opportunities for community involvement.

The clinical component is composed of standard medical program such as triage, exam rooms, observation rooms, laboratory, and pharmacy. The clinic provides anywhere from basic medical services to eye and dental care. In the proposed third phase of the project, a medical suite is included in order to fully encompass the needs of the local population. The waiting area of this component takes place in a designed intermediate space for comfort and ventilation. It is also articulated with a strategic color system in order to provide way-finding.

PREPARING FOR RAIN

When it rains, it pores in Haiti. So its important to keep rain from blowing into the building. woven palm wscreens used as windows and doors allow air to flow while keeping the rain out.

FORM

The plan of the complex is organized in a way that allows for both easy way-finding as a visitor of the clinic and also provides a sense of community. It achieves these things through the use of a courtyard scheme. The primary programmatic components of the structure are organized around a central courtyard that provides not only a large community space, but also allows adequate ventilation throughout the complex.

The courtyard is divided by a series of stepped concrete walkways. The steps of these pathways allow for additional seating and the pathways are placed in a way that relates exam rooms to the observation room, laboratory, and pharmacy. The pharmacy is located upon exit of the complex and can also be easily accessed from the street.

MADE IN HAITI

Another underlying concept of the Clinic Community is the commission of local artisans and craftsmen to create a comforting and recognizable environment for its visitors. These commissions would take form in everything from furniture and millwork to seasonal murals and wind chimes.

SEATING

The seating is made from painted #5 rebar and sealed palm wood and would be made by local craftsmen. Since much of the seating is in a semi-enclosed area slats afford a surface that would allow rain to run off.

Final Boards

Eben-Ezer Medical Clinic Expansion

View from Waiting Area to CourtyardNestled in the unique culture and landscape of Fort Liberte, Haiti, the Eben-Ezer Medical clinic helps fill the gap in healthcare that plagues the northeast corner of the country.  To increase their scope of services, the current clinic is in dire need of an expansion.

Our proposal reacts to both the culture and environment of Fort Liberte.  The existing building’s structural grid is to remain intact; however, it is being modified to hold the waiting and check-in areas.  To prevent confusion for the returning patients after the renovations, the new entrance is located near the current location.  Opening of the building allows for better cross ventilation through the existing building—which was previously an issue.  This creates an area sheltered from the harsh sun, but still connected to the natural landscape of the site.

First Floor PlanTaking advantage of all the sustainable aspects of the environment, the new buildings are oriented to the natural wind and lighting patterns of the site.  This is even more apparent in the building section; clerestory windows allow more natural light to penetrate into the building, as well as, vents at the base of the walls promote stack ventilation to cool the occupants and let contaminated air to clear out faster. Typical Building Section

Because doctor visits are family affairs, ample space is allowed for the family to be included in the healthcare process and education by varying scales of indoor and sheltered outdoor spaces, while being surrounded by plants used for both eating and medicinal purposes, and orienting gathering spaces around the class pavilion.  

Materials Palette

Eben-Ezer Medical Clinic Addition

analysis of a hibiscus flower

One of the critiques that resonated with our group came from a previous peer, Dani Collins. Dani brought a lot of great perspective to our design because she has previously been in the Haiti studio and had the opportunity to travel there with the college. She complimented our thoughtfulness on our concept of the hibiscus flower that reflects the culture and environment and mentioned how it reminded her of the vibrant personalities of Haitians.

program adjacencies

With concern to the culture, she told us about the need for organization, and that even without much the Haitians display a keen knowledge and need for a system organization. Moving to our two design options, she directed us to stick with our original plan because of the symmetry and systematic approach. She said it mirrored our original diagram better and that we should push for furthering this idea with the greater opportunity for obvious circulation, a clinic register system, ventilation, and other elements that went along with our heuristics.

original floor plan

Overall, the critiques were beneficial in helping us to focus on one plan and to further our concept as well as design. Moving forward, our next steps are to take the preferred plan and diagram in greater depth by adding finer details. The diagrams will help us understand the hierarchy of spaces and in turn tighten up the plan and add tertiary elements like storage and utilities. We will also put more of a focus on the construction details with ventilation, daylight, and materials.

Foundry Presentation Board

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.