Eben-Ezer Medical Clinic

Final Presentation Boards

Front entrance to the clinic.The expansion to the Eben-Ezer Medical Clinic in Haiti posed several unique problems that resulted in thoughtful results. The programmatic elements already present within the clinic were expanded upon to give the town a larger and more efficient clinic to serve the people of Fort Liberte. The design was driven by eight main heuristics: clear circulation, simple construction, passive ventilation, natural lighting, water collection and filtration, landscape architecture, regional materials, and privacy and security. These goals were implemented into the program: a waiting and check-in area, exam rooms, a lab and pharmacy, observation room, and staff facilities.

Floor Plan

The heuristics were the main driving factor behind many of the design decisions made within the clinic. The clear circulation determined the simple u-shape. This allows patients to clearly find their designated exam space and other key points within the clinic. The consistent eight inch grid overlaying the entire space, allows simple and easy construction for the Haitians. Passive ventilation and natural lighting were a given because of the lack of guaranteed electricity in Haiti. Louvered windows allows for natural light to filter into all interior spaces, as well as to take advantage of the north, north-eastern winds coming off of the neighboring bay. Water collection and filtration is also an important element in the design. There is no current system to provide running water to the people of Haiti, nor is there any filtration system. A system within the clinic would allow the rain water to be collected during the rainy season to provide the clinic with running water when needed.

Front elevation of the clinic.Section of the Eben-Ezer Medical Clinic.The last few heuristics were accomplished by establishing a central courtyard for additional waiting space and an area for educational purposes. The main concrete structure with the lighter wood columns uses common materials already found in Haiti. Iron work used for security purposes also uses regional materials and creates job for the local community. The privacy is accomplished by providing exam rooms for a single patient and curtains around the beds in the observation room. The clinic will provide medical help to the people of Fort Liberte through a simple and thoughtful design.

Transitional circulation space between exam rooms and courtyard.

Haitian Clinic

Design for the expansion of the Eben-Ezer Medical Clinic, Fort Liberte, Haiti

The problems associated with constructing a viable clinic in an impoverished nation such as Haiti are many.  With problems ranging from malnutrition, lack of medical supplies, poverty, illiteracy, and natural disasters this countries people are destined to a hard life and an early death.  To mediate the severity of this crisis in Haiti I concentrated on the positives of the natural environment.  The early explorations into the site lead to the development of a module that was orientated to capture both the wind and the light.  This design gave way to the final design scheme which oriented the visitors to the site by positioning them within the center.  This approach to orientation was essential to locals due to their inability to read and their unfamiliarity with the steps involved with receiving medical care. 

                The program that was associated with the project was the inclusion of six exam rooms.  These rooms were to allow plenty of ventilation and limited occupancy through their small size.  Two rooms for empower and advance were provided these would serve as bases of operation for the outreach from the clinic.  A six space observation area was designed to isolate a severely contagious person and to provide viewing areas of patient reactions to medical treatment.  Other programmatic elements included a check-in, dormitory, physician’s residence, and office space.  The major element of incorporated into the existing building was the combination of a lab/ pharmacy area.  This was located in the renovated ground floor and was to serve as a secure and easily accessible location from the central waiting area. Due to the pay as you go approach to health care that is associated with this clinic it thus became very important to limit areas where monies would be collected and stored. 

 To provide for the educational component to the project vegetable gardens, herb gardens, and orchards were provided to teach the local peoples of the importance of proper nutrition and its ability to prevent many of the most common ailments like different forms of skin disease.  Due to the rise of cholera following the earthquake of 2010 the site would also host composting toilets to educate the local populace on the importance of waste disposal.  There would also be a cistern buried on the site with a G E purification device to provide potable water for drinking and bathing.       

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

Reflection: After the Foundry

My group (Tiffiny Hall and Alyssa Nealon) presented both the Emergency Medical Response Unit and the schematic design of the Eben-Ezer Medical Clinic expansion.  We felt the mobile medical unit was valuable in the development of the clinic’s expansion.  Many of the lessons learned through the first project were essential in understanding the cultural and medical needs of Haiti; this confidence in our knowledge of the projects and culture helped us communicate more easily with professionals and professors. 

Floor Plan: Program and Square FootageThe Foundry was beneficial in many ways.  The professionals as a whole were very supportive of both our projects and did not point out any glaring issues.  They commended our research, circulation solution, and site usage.  One of our reviewers, who grew up in Southern California, gave us an interesting perspective for design development; she suggested looking at buildings in similar climates and how they address sustainability and circulation—where she thought we could use assistance.

Site Plan: Access and Circulation Parti

From this point, we need to further develop our design.  Many decisions have to be made involving the sectional qualities of the buildings.  The building in plan takes advantage of the sun and wind; however, the section of the building could negate this if not designed correctly.  The concern of non-sheltered circulation is an issue that needs to be addressed.  Also, the materiality and construction methods will greatly affect the look and feel of the environment; research of local materials and methods is needed to determine the best options for our design.

 Sectional Options

Foundry Board Presentation

Furthering Design Insight at the Foundry

Eben-Ezer Clinic Sheet1

Eben-Ezer Clinic Sheet2

Haitians are often scared when they arrive to a hospital. The general chaos and lack of experience in healthcare environments heighten anxiety. The first goal of our project is to increase awareness of the healthcare service flow as well as reduce anxiety. The design functions around a central greenspace that allows for greater clean airflow throughout the site. The clarity in spatial organization as well as distinct nature of circulation paths will help to ease unnecessary fear or anxiety. 

Clinic Complex; visibility is important for order

Our collaboration with the nursing students has been intensely helpful if not fundamental in this project. Stasia was able to give us great critique and insight into different aspects of healthcare. We discussed alternative hosiptal models and methods. In our discussion we analyzed healthcare practices with a critical eye. Stasia told us about medical facilities in Jamaica and about some of her ideas for the healthcare model. Instead of a family making an appointment for one person, the family could come together, pay once, and have everybody looked at in one sitting. Haitians travel in families. We also discussed the social infrastructure of the culture; in lower income societies, family is not just a priority but a necessity. Families support each other and protect each other. Haitians show up to doctors' appointments with their entire family. We discussed how to cut down on costs by making use of the social structure and customs. Instead of having an individual hired on to cook and take care of people, the hospital should allow the family members to come and take care of the patient as they would at home. The patient could enjoy foods they are familiar with as well as enjoy the healing benefits of being taken care of by a loved one. The building should form around the culture. 

In its form, the clinic will function as a complex rather than a large imposing structure. This breaks up the clinic into smaller chunks of information that are easier to digest; Haitians are able to see where people are waiting, getting examined, picking up medicine, and leaving. This helps the Haitian to understand what to do as well as creates order (thus increasing security) in the space. Visibility is a huge part of the project for this reason. Patients should be able to easily understand what to do without literally being able to see into the exam rooms. 

Programming Schematic

Conversing with a professional architect was helpful; we discussed alternate methods for bringing in natural daylight into the space. We discussed different forms of toplighting and talked about cooling and thermal mass. Will the building be cooled and air cycled through the building at night?

Schematic Section 

Discussing our project with classmates and professionals at the Foundry allowed us to make great progress in our thinking. We are taking these ideas and pushing our design further. The program is shifting in order to accommodate better ventilation through the building. Efficient circulation and high visibility will determine the success of the program.