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

Complete Project Page 1

Complete Project Page 2

 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.

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). 

U-Haul-spital Medical Trailer

Unpacking Trailer Process When designing a mobile medical unit for Haiti, Alyssa Nealon & myself knew it had to be compact and easy to understand. We faced many challenges with materials, the terrain, and the ease of setup. In the end we designed an offroading trailer that housed 7 medical carts, loaded with supplies, and 6 tents with mosquito netting. We made the trailer blue and white to mimic the United Nations color scheme, which played a positive role in the Haitians lives. The design offers a multitude of setup options to allow for multiple scenarios, whether it is de to the amount of workers or difficulty of the terrain. Modularity was a driving force in this design. But, designing modularity in a simple way, so that the Haitians could understand it easily was a real challenge!

Medical Cart Design

The Medical Carts serve a vital role in the U-Haul-spitals goals. It needed to serve as many purposes as possible in a very small footprint. The 2'W x 2'L x 3'H cart has 6 drawers, all of which are color coded for quick and easy location of items. The colors represent:

Gray- Evaluate

Blue- Administer

Green- Prescribe

Yellow- Emergency

Orange- Medicate

Each of the colored drawers house all of the supplies needed to do that particular task. The cart is also equipt with a pull out dictation tray for the nurse to use as a writing surface, a removable sharps container located on the back, heavy duty wheels on the back and adjustable feet on the front, 2 cushioned stools on top, and a locking mecanism on the side to be able to connect multiple carts together in case of the need for a gurney. When not being used as a gurney the 2 cushions, located on top, can be removed and unfold into two 1' x 2' stools for the nurse and the patient to sit on. The stools are upholstered with marine grade vinyl, similar to what is used on boats, so that it may be able to be cleaned easily.

Perspective view of U-Haul-spital in use

A few things critiques that were mentioned in the review were:

-Negatives-

the lack of thought on how the trailer connected with a mule

who owned and opperated the trailers before, during and after use

who was in charge of restocking the trailers after inital use

-Positives-

the color coding system of the carts

the amount of thought and research that went into the dispursing of the units

the modularity of the design

The Kabwet Clinic

The Kabwet Clinic helps to both bring medical aid to Haitians in need that may not otherwise be able to travel to or afford a visit to a hospital.  It combines modular, secure storage units with a durable, versatile cart to bring supplies and opportunities to the more remote, rural settings of Haiti.  The cart was designed to travel over most terrains, to be easily repaired with the replacement of readily available parts (i.e. used car tires, scrap wood/metal), and to transform from a vehicle to a work surface.  

Transformation of Cart into Table

 The cart would be stocked and distributed from hospitals around the country.  They can be loaded onto a truck, towed by motor vehicle, donkey, or pushed by person.  This style of pushed cart is often used in Haiti, but with more found materials and handmade construction.  This cart could be manufactured in the US, but the use of simple construction techniques would allow for more carts to be built in Haiti with whatever material is available.  

Cart functioning as a work surface

The storage containers were designed for multi-functionality in that they are water-tight containers, can be used for seating or work surfaces, and include a detachable connection that allows for the use of other found containers with the entire unit.  A critique given about the containers was that they would initially have to be fabricated in the US, an unlikely and difficult solution to the problem at hand.  With the design of a specific connection detail, however, virtually any container could be used in this mobile clinic system.  

Connection Detail

One of the features of the Kabwet Clinic is the break-away medical kit.  In a response to an emergency, it would be used, once the cart had arrived to a village and set up camp, to venture into the more remote locations to address any problems found.  The break-away kit would also be used to travel to rural homes and help educate citizens on proper first aid.  One of the most frequent causes of serious injury or infection is the mistreatment or neglect to care for minor injuries when they first happen.  The break-away kit includes graphic directions to address the language barrier, and to help educated Haitians on proper first aid techniques.  

The Break-Away Kit

Update on Sunday, February 17, 2013 at 3:20PM by Mitzi Coker

I really like the design of the Kabwet Clinic.  The efficient use of space and the carts ability to be transformed into an examination table is a great idea.  The over-all design is pleasing, compact, and well thought out.  I think your thoughts on having the containers (baskets) woven by locals is a really good idea.  Everything that can be manufactured locally is great for the economy and also less expensive due to shipping costs and transportation issues.  Just curious...How did you come up with the name of the clinic?  Did it have to do with the tires you used on the cart?

Mitzi Coker