OVERSEAS HOSPITAL CONSTRUCTION
At Shai-Osudoku Hospital, maternity mortality cases have been reduced to zero, compared with 2,000 annual cases – authorities attribute this to ‘good infrastructure, the commitment of staff, and quality healthcare’.
Five-year review The client recently carried out a five- year review of the building and its fabric. Departments within the hospital had moved and changed, and the buildings had adapted. What was clear was that the buildings were subject to forces from the elements and from daily use. In our ongoing projects we have learnt from this by deepening roof overhangs to give even greater protection from sun and torrential rain. Internal walls are often on the receiving end of things like trolleys and other equipment, and thus benefit from wall protection. Budgets for these hospitals are constantly tested to provide the greatest number of facilities, but this needs to be balanced against the capital costs of creating truly robust and long- lasting environments.
Another selling point of our design is the hospitals’ ‘pandemic adaptability’ – the shallow plan and courtyard form is naturally adaptable to adaptation for use when a pandemic occurs. The single- storey building form features a number of possible entrances, all of which can be sectioned off and operated independently. We have also discussed the provision of designated pandemic hospital zones, which feature a hardstanding area, complete with a dedicated service building. This area can be used to build ward marquees and support services.
Making all welcome We want to make the hospitals we design environments where everyone – patients, visiting friends, and families – feel welcome. Making the hospital feel this way can go a long way towards aiding the recovery of patients. It’s part of a salutogenic approach to hospital care; one which focuses on the health and wellbeing of patients, rather than merely on the ailment that brought them there. Creating a well-designed hospital
environment also benefits staff. African hospitals often bear the brunt of a drain of talent, as local health professionals seek opportunities overseas. By helping communities build well-equipped, well- resourced hospitals that staff can see are responsive to the needs of the local
community, workers can be encouraged to remain, doing what they do best. This can be enhanced by offering them good quality living accommodation on site – an important benefit for those working in hospitals located in remote rural areas. In addition to the eight hospitals
we have already delivered across the continent, tp bennett is currently involved with the delivery of 14 hospitals in Côte d’Ivoire and Gambia.
‘Zero tolerance’ for maternity mortality The impact of these new hospitals on local healthcare outcomes has been considerable. In the case of the Shai- Osudoku District Hospital, Medical director, Dr Kennedy Brightson, initiated a ‘zero-tolerance policy’ for maternity mortality, and within five years the incidence in the area has been reduced to zero, compared with 2,000 annual cases before the policy came in. The hospital’s authorities attributed this to what they called ‘good infrastructure, the commitment of staff, and quality healthcare’, a point echoed by the country’s health minister, Kwaku Agyeman Manu, who pointed to what he called ‘a well-motivated workforce’. Word of the hospital’s success has
spread. It has been identified by the World Health Organization as a possible benchmark for other health facilities across Africa, due to its infrastructure and the delivery of its services. We are proud of the achievements of both our team and those working on the ground across sub-Saharan Africa to bring about radical and beneficial change for those requiring hospital treatment. Looking ahead, we have considered how
we might change our delivery approach. We are working with NMS Infrastructure to develop standardised departments within the relevant construction teams, and expand the ‘kit of parts’ concept of creating the components for a hospital. As well as shortening the design time, it could reduce the potential for delays during a procurement period, since materials and equipment could be ordered in packs. We are also developing the design
model so that it will be easier to expand a hospital in the future, creating additional wards or new clinical areas, making them easier to build, more adaptable, and cheaper to run. Communities across sub-Saharan
Africa deserve the highest standards of healthcare. There are numerous reasons why in some parts of the continent this is not the case. However, the hospitals we are designing, along with the dedication of those on the ground who build and then work in them, delivering the care people need, are playing their part in addressing the healthcare gap to the point that hopefully, one day, it no longer exists.
Polly Barker
Polly Barker is the Healthcare lead at tp bennett, and has extensive design and project management experience. After gaining experience in the retail, commercial, and residential sectors, she started to specialise in health and education, and now has over 20 years of specialism in this field, both in the UK and internationally. She currently acts as the practice’s Construction Design and Management (CDM) manager, offering advice, and coordinating policy and procedure, regarding health and safety in design and construction. She is also an active member of the Sustainability Group, responsible for promotion of sustainable design.
October 2022 Health Estate Journal 77
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