Eben-Ezer Medical Clinic Addition

Site Plan

FROM THE OUTSIDE-IN:  to maximize cooling within the buildings, waiting spaces for patients and their families occur in outdoor courtyards and covered areas.  Further waiting for children, families, and patients alike may also occur below the mango trees planted throughout the campus.  By keeping patients and families on the outside, security and sanitation are maximized while heating is minimized.  With these factors in mind, the addition and existing must be designed from the outside-in so that the buildings contain multiple layers of privacy rather than a clear-cut line.      

THE ROTATED CENTER BUILDING:  rotated to align directly east-west for ventilation and solar benefits, the center building creates a more subtle turning angle into the site from check-in.  Additionally, by splitting the building into two parts, the center pinwheel point creates a resting space and area for recollecting families or thoughts before moving to the pharmacy or other parts of the campus.  This space may also be used for waiting and rest for the entirety of the site due to its central access.            

DOUBLE-HEIGHT ENTRANCE:  this entrance (section below) provides an indication of entrance (though patients line up infront of the existing building) and allows views into the complex.  This glimse into the campus gives patients a chance to understand or view what to expect from their visit.  This glimse is not intensive--visitors and patients waiting for check-in are not looking into exam rooms--but it would allow for a showing of activity, circulation, and waiting within the campus.

Concrete covered walkway (green), walkway in under building roof (blue)Patient paths

CONCRETE CONNECTIONS:  to cover the patient paths and general walkways, two different methods have been used.  Spaces in blue indicate wooden trusses and metal roof overhead that would extend from the building structure itself.  Spaces in green indicate a concrete connecting cover that would form from the side of the buildings and extend over walkways and seating.  This covering would be somewhat lower than the roof overhangs to allow provide shading.

OUTDOOR WAITING SPACES:  a variety of waiting spaces have been designed to discourage a feeling of mundane similarity.  Linear waiting is provided near the exam rooms and laboratory so that patients may be called in order and moved quickly through the space.  In the pharmacy and central pinwheel area, waiting is clustered into an area or zone with the understanding that these spaces tend to see a high volume of patients and families.  

Street elevation

SIMPLE AND LOCAL:  As per the heuristics SIMPLICITY and LOCAL AVAILABILITY, the campus must be feasible within the scope of Haitian technology and construction methods.  After much research and precedent studies--all resembling those directly below--it became clear that concrete frame with block infill was the most popular and practical.  In this sense, this method of construction does not stretch the technological methods available in Haiti and can build off the strengths of their existing construction industry.  Overhead, wood site-fabricated trusses and metal roofing (Haitian-made of course) take further advantage of the construction methods existing in Haiti.  Additionally, all materials that comprise the building should be found locally with exception given to the wood elements, in which case, Ft. Liberte’s proximity to the Dominican Republic is very beneficial.    

Eben-Ezer Medical Clinic

     After an in depth study of Haitian culture it was evident that our project would include several aspects of Haitian life.  Our concept integrated the Haitian culture with a focus on the patient’s needs.   After working through a conceptual design surrounding Haiti’s hibiscus flower, we turned our focus on combining this with the programmatic elements. This process led us to a schematic plan surrounding a centralized courtyard that’s functions serves as a waiting room that accommodates the larger Haitian families. Most Haitians visit a medical facility once if ever in their lifetime, and when they do they are typically scared and nervous. Then central courtyard removes the mystery of where family members are being taken to.

     Circulation plays a key role in designing a Haitian clinic.  There are many different patient paths that could easily become confusing to a first time visitor.  We spent a large portion of our design development focusing on how to incorporate patient circulation with program adjacencies.  We therefore created the most direct patient access to the specific needs of each individual patient. In the clinic the circulation translates into a "U" shape following the exterior of the courtyard.  The "U" shape creates one single path of circulation minimizing confusion and congestion.

      The program of the clinic includes a check-in area with plenty of storage for records.  It is located in the front of the clinic parallel to the fence opening.  Once passing through the check-in one would enter the waiting area which combines an interior and exterior experience that proceeds to the central courtyard.  The exam rooms are next on the circulation paths.  There are six exam rooms and two specialty exam rooms that are designed with clerestory windows and pitched roofs to allow for ventilation and natural light.  On the back of the site is the lab area: because of its limited patient access it is blocked from the public courtyard by a lattice system. Opposite the exam rooms is the observation facility which also has clerestory windows and a pitched roof system to allow for ventilation and natural light.  The final stop on the patient path is the pharmacy.  The pharmacy is located in the front of the site adjacent to check-in and records.  It is important for the pharmacy to be near the exit due to the large amount of congestion that will occur there and they fact that almost all of the patients will need to go there before leaving.

Medical Clinic Addition

Summer solar path diagram

The parti is derived from existing mirrored circulation spaces, extension of the grid, and site conditions.  Parti first developed from mirroring existing circulation spaces so that the scale of the addition would remain the same.  Extension of the grid guarantees that the scale and structural grid will relate and integrate well (and similarly to the existing).  Deviation from the existing design occurs at the rotation of the structural grid.  This grid pivots ~25 degrees clockwise so to be aligned west-to-east for maximum northern light exposure in exam spaces and ventilation accessability to the north-northeastern breezes. Circulation is kept to the exterior so that minimal people are inside the building and the temperature is kept down (more people = warmer building).  Progression from the check-in to the second (middle) building for general exam and observation is direct and private.  Circulation is on the southern face and covered to provide protection from the rain for those walking and shading from the sun for the exam rooms.  

Site section facing east. The biggest critique was to examine the relationship between the two grids (the original and the east-to-west) and articulate the intersection between the two.  At the time of the critique, the two grids were overlayed on top of each other with no articulation at the intersection or pivot at the edge.  One suggestion was to create a breezeway that slices through the addition in line with the original grid.  At this time, the intersection and connection has been articulated through the pathways so that pathways leading to and from the addition (to the original building) are on the original grid.   

Roof structure encourages ventilation into the building while shedding rain.

Next steps include further examining the circulation, roof structure, and phasing of the project as a whole.  The courtyards (central and rear) will be further developed for privacy, seating, and ventilation.  Any seated area will be shaded.  Windows to exam rooms face north and are unobstructed.  Pathways and the first waiting area will be further developed and more closely analyzed.