Redesign of Tambacounda Hospital’s Maternity and Pediatric Units
The Tambacounda Maternity and Pediatric hospital redesign builds upon 15 years of extraordinary work in rural eastern Senegal by the Albers Foundation and Le Korsa. Echoing Josef and Anni Albers’ shared ethos and belief in the use of “minimal means for maximum effect,” this project goes far beyond a single architectural structure, embedding itself within the local community, economy and landscape.
Tambacounda Hospital – the only major hospital in the region – is a vital resource servicing over 40,000 patients per year from the surrounding area, stretching across the border into Mali. The doctors had previously been working under extremely difficult conditions, with the original design leaving the communal spaces severely overcrowded. The design of the new Maternity and Pediatric Hospital brings a sense of coherence and greatly improves the comfort of patients and their visiting families. Herz’s structure comprises a two-story building in a curvilinear form which brings two clinics – pediatrics and maternity – together under the same roof and offers approximately 150 hospital beds. The extensive length of the building allows for the smooth circulation of staff and patients and accommodates multiple communal spaces both between the rooms and in the courtyards formed by the bends of the S-curve, turning it into the truly social spine of the hospital.
Herz’s design includes several passive climate design innovations to combat the challenges posed by the extremities of the local weather, and to help forgo the need for air conditioning. The building is characterized by a narrow width of only seven meters, a feature which allows for all the rooms to be aired and cooled naturally through cross ventilation. In addition, his mashrabiya-inspired use of lattice-like brickwork with apertures has the advantages of blocking sun and facilitating air circulation, whilst also giving the hospital its distinctive recurrent visual motif and its beautiful play of light and shade. A second roof covers the primary roof of the extension, repelling most of the direct sunlight and creating a chimney effect which draws the heat upwards and out of the rooms below.
Herz has collaborated at all stages with local leader Dr. Magueye Ba and depended upon the expertise of the community, working almost exclusively with craftsmen and engineers from Tambacounda and the surrounding villages, and thereby helping to provide employment and support for the rural economy. The holistic nature of the project has helped generate further infrastructure for the area beyond the hospital; a façade created at an early stage by Herz and Ba to examine how the bricks functioned in the climate was subsequently incorporated into a new school Le Korsa was building in a nearby village. In addition Herz and his wife have designed a playground for the hospital. A sensitivity to the local landscape has also been a key facet of this multi-dimensional project, with Herz’s design endeavoring to create as little disruption as possible to the local trees. Following the completion of the Maternity and Pediatric Hospital, Herz will build staff quarters to help attract more doctors from the city, in a design inspired by a print by Anni Albers.
Overview
Tambacounda Hospital is the only hospital in a very large region of eastern Senegal. Because Tambacounda is a crossroads of major international routes, in a country where the roads are in bad condition and often dangerous, its emergency room treats, each month, some 300 victims of car accidents. The hospital also takes in patients who need levels of medical care that cannot be provided at smaller clinics in the region, including those supported by Le Korsa in the villages of Sinthian and Fass.
Le Korsa’s history at the hospital goes back to 2004, when Nick Weber made his first trip to Senegal. Taken to the hospital by Dr. Gilles Degois, who was delivering a supply of desperately needed blood from Paris, Nick was surprised by the woeful conditions at this hospital, where the hard-working and devoted doctors and nurses pointed out a paucity of equipment. The only operating table was broken, and a room set aside for surgery had no working surface at all, the table destined for the hospital having been stolen in transport. An incubator essential to the survival of prematurely born babies consisted of three naked light bulbs hanging over a steel shelf from a discarded refrigerator. Masses of patients, ranging from newborns to the elderly, were waiting outside in the blistering heat, unsheltered for hours, in the hope of care. Some of them, unable to pay for medicine, were denied treatment of any sort, since, while the staff’s modest salaries are funded by the state, antibiotics and other drugs are not, and the doctors and nurses are unable to perform surgery or offer other treatments to patients who are unable to afford these basic drugs.
In 2010, Le Korsa forged a partnership with Tambacounda hospital and its dedicated staff to cover the cost of such medicines for the patients who could not afford them, thanks to a meeting organized by board member Dr. Patrick Dewavrin and Dr. Ammadou Milogo, the hospital surgeon and its former director. This program is overseen by Ms. Khady Guèye, one of those individuals who is a true partner to Le Korsa in Senegal. This remarkable, compassionate, and shrewd human being is, single-handedly, the hospital’s Department of Social Services. She determines whether the needs of a patient are so dire that he or she should receive a subsidy provided by Le Korsa, or whether patients who plead poverty can actually afford the small amounts needed to pay for painkillers or malaria drugs. Twice a year, Le Korsa gives the hospital a grant of $5000, and Ms. Guèye provides us with every receipt for the medicine she decides to purchase on behalf of patients. We have helped to modernize her office by providing a computer, printer, and digital camera to make her work more manageable.
We also regularly send containers of medical equipment from Project C.U.R.E. to the hospital, which helps provide crucial beds, operating tables, and basic supplies. Since 2015, we have sent three such containers, with goods worth over 1.5 million dollars.
