Places of Miracles (Chishamiso), which is the name of the children’s hospital that the charity Children of Fire is intending to build, will be a 50-bed burns children hospital that will cater for the health needs of children from various parts of Africa who cannot afford specialised surgeries. Chishamiso will be located in Francistown Botswana and will be a medical charity that will offer free treatment to children who have suffered severe burns.
Architectural plan for the hospital
Hospitals built in Africa tend to be built to replicate the hospital designs of the West. These designing methods do not consider the elements needed to be put in place when building in areas of high temperatures and varying climate patterns. The idea for Chishamiso hospital will be to build a hospital that has a design relevant to the characteristics of the site. Let’s say a tailor-made hospital. Hence, the climate, geology, political stability and the population of the area that the hospital is to be built will be considered.
And where did this idea begin?
When Dorah Jones was rescued from a fire in a squatter camp in South Africa at six months old, she was so badly burnt that three of the hospitals she was admitted to all stated that she would not survive. Children of Fire Trust and Children of Fire International charities were eventually formed in Johannesburg, South Africa and London, the United Kingdom respectfully and are now assisting other children across Africa who have been affected by severe burn injuries to get reconstructive surgeries.
Building a hospital that would ensure that the treatment for the burned children is faster and easily accessible to prevent further damage to the skin and also to move from individualistic treatment to a collective treatment were part of the reasons why Children of Fire, as a charity is considering the construction of a hospital in Francistown Botswana.
Botswana being the least corrupt country in Africa and the most politically stable, has made it an attractive location choice for this dream hospital “Chishamiso” in Francistown. There is a need for a burns centre that should be conveniently located to cater for burns paediatrics patients from Botswana, Zambia, Namibia, South Africa, Zimbabwe, Congo and other countries where such treatment is not easily accessible.
According to Household Energy Safety Association South Africa, children in Africa who are under the age of five, have a three times higher chance of suffering burn injuries than children worldwide. With these statistics, there is need for a paediatric burns hospital in sub-Saharan Africa that would cater for those children who have no access to treatment and hence will eventually improve their quality of life. In addition, a training facility within that region is needed to enable health practitioners to gain more knowledge and current information on the different approaches to burns surgeries and also on other important and neglected conditions like keloid scarring management which at this point has no cure but can only be managed.
What architects could do
Chishamiso Hospital will need a 21st century design that will be sustainable, renewable and energy efficient. The core aspects of climate are important factors to consider when designing a hospital building. The climate in Francistown is considered as subtropical steppe or in other words, low latitude semi-arid hot climate. Therefore, when designing the building, important factors like water conservation and making use of renewable energy like solar energy and wind energy is important. The amount of rainfall, temperature and humidity will determine the type of vegetation that the area will have, it will also determine the water sources around the region and availability of both ground water and rain water and also the types of animals and the public health issues that might affect the community.
Designing the building for Solar and wind energy
Solar panels can provide 100% renewable and free energy by converting the sun’s energy into electrical current. In order to maximize on the benefits and savings of the solar panels, one should design the roof angle facing north, if the location is in the southern hemisphere. Roofs should also be un-shaded between 10 a.m. and 4 p.m. Temperatures in Francistown Botswana can reach average heights of 25 degrees Celsius in January and this can be a good opportunity to harvest solar energy.
Inclusion of a preliminary survey of the geology of the area is an important aspect because it determines the type of rocks in the area, whether porous or aquifers and also determines any natural hazards like presence of earthquakes, tsunamis and landslide. Botswana being a land locked country is not prone to tsunamis.
Extreme shortage of water however is a major problem especially in Sub Saharan African countries. Building a hospital in Botswana – a landlocked country should make allowance for installation of both black and grey water recycling processes.
Why should architects be interested?
Architects and engineers are needed to design this hospital. When this dream is realised, burned children like Basheeba above will have a beautiful environment where they can quickly heal. People from different countries and throughout the African continent would be able to access qualified surgical treatment from Chishamiso hospital.
Building materials can be easily accessed in Botswana. There are various construction companies that provide these bricks and concrete for building. Clay mining is also practiced and there are different quarries in Botswana. An example is Francistown quarries which is located opposite metro light industrial area. Other quarries include Kgale Quarry, Debswana corporate centre and Bela Bela Quarries.
Butaro hospital’s design in Rwanda is one design to match. It incorporated a range of innovation that aimed to reduce the risk of infection and involve majority of the community in its planned construction.
Use of non-permeable floor finish can prevent presence of joints that would be otherwise a dwelling place for bacteria. This continuous level floor is easily cleaned, long lasting and does not provide a site for infection growth.
Chishamiso will be a two storey design with majority of the patients on the ground floor while the administration and study/research on the first floor. It will also have a helipad at the front and the main door will have an atrium design. This will create a dynamic working and resting area that helps stimulate the users to have a connection with the outside environment.
Use of local labour during building is a cheaper and faster option as opposed to heavy excavating machinery. Involving the local community creates employment opportunities and enables the local people to feel as part of the project.
Patient’s beds should be facing towards the windows for them to enjoy the landscape and have natural ventilation. Use of ventilation equipment should be designed for African hot weather and be well maintained. Hallways should be excluded from the design plan which should ideally have an open plan waiting area for the patients.
Natural ventilation should be considered instead of air conditioning. It changes the air up to 15 times an hour. This would reduce the spread of air borne diseases. The use of natural ventilation involves the incorporation of air pressure difference, wind funnelling and use of patient body heat to get rid of contaminated air.
To mitigate the risk of spread of infection, the use of bactericidal UV lights should be considered. The demerit is that due to the high dust quantity in most parts of Africa, pathogens tend to stick to the dust. The UV is not able to penetrate through the dust or even through corners. When drying the hands, the use of electric hand drying machines is not an option because it leads to the circulation of dust particles while pathogens stick to the dust.
Building a hospital with sustainability in mind will lead to a reduced carbon footprint, reduced costs and also create an open space which will be beneficial for the quick healing of the patients.